Paging Dr. Mom

One of the many hats that parents wear is that of a “first responder.” When their child is sick, they are the first to assess the symptoms and treat the illness. It’s a role that parents should become comfortable with, considering that most children develop the flu or an ear infection at least once in their first years of life and catch eight to 10 colds before age 2.

Resist antibiotics

When your child is sniffling and feeling miserable, you may think that a prescription medication will bring on a speedy cure. Antibiotics can help some bacterial illnesses, such as strep throat, but many common illnesses, such as colds and flu, do not respond to antibiotics, because they are caused by viruses. These illnesses are best treated with rest, fluids and acetaminophen or ibuprofen to manage fever, says the American Academy of Pediatrics (AAP).

Antibiotic misuse—when these medications are mistakenly used to treat viral infections—has become a serious public health problem. Misusing antibiotics contributes to antibiotic resistance, or the point at which bacteria become so overexposed to antibiotics that they adapt to them. Increased resistance requires the use of more potent antibiotics; the danger is that these more potent drugs also may become ineffective.

You can help prevent the spread of antibiotic resistance by not insisting on an antibiotic for your child when it is not necessary.

When medication is needed

For illnesses that require prescription medication, follow the instructions carefully. Be sure that your child completes the full course of the medication, even if he or she appears to recover beforehand, the AAP says.

Talk to your child's health care provider for advice on over-the-counter (OTC) medications to relieve your child’s symptoms. Never give your child aspirin, because it may cause Reye’s syndrome; instead, give ibuprofen or acetaminophen. Your child's provider can advise you on the appropriate dosage based on your child’s weight. Choose only OTC products that are specially formulated for children.

Here is a brief guide to treating the most common childhood illnesses. Knowing what to do when your child is sick takes experience, reliable medical information and a good relationship with your health care provider. Always trust your instincts when your child is ill. You know your child best; if you are concerned about your child’s symptoms, call your provider.

Bronchiolitis

Respiratory syncytial virus (RSV) most commonly causes the symptoms of bronchiolitis: a runny nose, lack of appetite, fever, cough and wheezing. Treatment for RSV infection largely depends on your child’s age and the severity of the illness, the AAP says. Call your health care provider if you are concerned about RSV.

Colds and flu

The symptoms of a cold are a runny nose, nasal congestion, cough, fatigue, scratchy throat, and sneezing. Flu, a more significant illness in children, often causes many of these same symptoms, as well as chills, headache, muscle aches, and fever. Both illnesses are caused by viruses, so rest and fluids are the best medicine. OTC medications in dosages for children may help relieve symptoms while the virus runs its course. These may include decongestants for congestion; dextromethorphan for coughs; guaifenesin as an expectorant; acetaminophen or ibuprofen for fever; and electrolyte drinks to prevent dehydration. Talk to your health care provider about how to use these medications.

Croup

A croup infection causes the voice box and windpipe to become inflamed. Your child may have a startling, barking cough, especially at night, the AAP says. Neither antibiotics nor cough syrup relieves croup. Many parents find that taking the child outside to breathe the cold night air eases breathing. Sitting in a steamy bathroom while a hot shower runs may improve breathing. Crying makes it more difficult for your child to breathe, so try to distract and calm him. If your child still has significant difficulty breathing, see your health care provider or the emergency room. Prescription corticosteroids can improve breathing while the child fights off the infection.

Ear infections

Otitis media with effusion (OME) is less serious than acute otitis media, because the earache is less intense and caused only by fluid in the ear. According to the AAP, OME calls for “watchful waiting” instead of medication unless the child is under age 2. In a child older than 2, treatment depends on the severity of the fever or earache. OME usually requires no special treatment, and antihistamines, decongestants, antibiotics, and corticosteroids are not recommended, the AAP says. If your child has persistent or troublesome ear infections, talk to your health care provider.

Fever

Keep in mind that fever is not an illness, but a symptom that your child’s body is fighting an infection. Monitor fever rectally for infants or in the armpit for young children, because young children often can’t keep a thermometer in their mouth. Ear thermometers work well for children of all ages, but they must be used properly. Be sure to call your health care provider about any fever in a baby 3 months or younger, or if fever persists for more than three days in an older child or if the child is lethargic or irritable, the AAP says. Your provider will help you determine the cause of the fever and develop the best strategy for treatment.

Pertussis (whooping cough)

Although most children routinely are vaccinated against this illness, pertussis has re-emerged as a potential health threat in recent years, the AAP says. Those who are now getting pertussis are teens or adults whose childhood immunization has lost its effectiveness. In response to this, a pertussis booster is now available for teens and adults.

Initially, the symptoms of pertussis are similar to those of a cold—runny nose, congestion, fever and cough. The cough increases in severity, lasting for longer spells, and it can even cause vomiting and breathing difficulties. Call your health care provider immediately if these symptoms appear.